Are you noticing any of these signs in a loved one?
When a loved one begins having trouble remembering names, finding the right words, or navigating familiar places, it is natural to wonder: Is it Alzheimer’s disease?
It may or may not be. Alzheimer’s disease is the most common form of dementia, but it is not the only one. There are several others.
Many refer to dementia as a disease. It is not. Dementia is a general term used to describe a decline in memory, thinking, reasoning, or other cognitive abilities that become serious enough to interfere with everyday life. While occasional forgetfulness can be a normal part of getting older, dementia is not.
Memory loss is not the only sign of dementia. Depending on the underlying condition, someone may first have noticeable changes in personality, behavior, attention, movement, language, or problem-solving.
The type of dementia a person has affects the symptoms they experience, how the condition progresses, and the kind of care and support they may eventually need.
That's one reason getting an accurate diagnosis can take time. The symptoms of different dementias can overlap, and some people have more than one type of brain change occurring at the same time.
Alzheimer’s Disease is the most common type of dementia. It is a progressive brain disease that gradually affects memory and thinking and eventually interferes with a person's ability to manage everyday activities.
Changes in the brain associated with Alzheimer's include abnormal buildups of proteins called amyloid plaques and tau tangles. These changes damage brain cells and their connections over time.
Memory problems are often among the first things families notice, especially difficulty remembering recently learned information. But Alzheimer's eventually affects much more than memory.
Symptoms may include:
The progression of Alzheimer’s disease isn't identical for everyone. Some people experience relatively gradual changes, while others may have periods when symptoms seem to change more noticeably.
It's also worth noting that having memory problems does not automatically mean someone has Alzheimer's. Other medical conditions, medication issues, and other forms of cognitive impairment can produce similar symptoms. That’s why a physician’s diagnosis is so important.
Vascular dementia occurs when problems with the brain's blood vessels interfere with blood flow and oxygen reaching brain tissue. A stroke is one possible cause, but vascular damage can occur in other ways as well. Symptoms depend heavily on which areas of the brain have become affected.
For families, the changes may look less like the classic "memory loss" people associate with Alzheimer's and more like difficulty with thinking and organization.
Symptoms may include:
The progression can also look different from Alzheimer's. Depending on the underlying blood-vessel damage, symptoms may appear suddenly following a stroke or develop in a more step-by-step pattern.
There is another reason vascular dementia can be confusing: vascular changes and Alzheimer's-related changes can occur together. In fact, vascular brain changes often coexist with other forms of dementia.
Lewy body dementia (LBD) can be particularly difficult for families to identify because its symptoms can look quite different from the memory problems most people associate with Alzheimer's.
LBD is associated with abnormal deposits of a protein called alpha-synuclein, known as Lewy bodies. These deposits affect brain chemicals and can lead to changes in thinking, movement, sleep, mood, and behavior.
One clue can be rapid fluctuations in perception and behavior. A person may seem alert and capable at one point, then become much more confused or inattentive later.
Symptoms may include:
Memory loss can occur with LBD, but problems with attention, visual perception, and higher-level functioning may be more noticeable initially than memory problems.
LBD is a bit more complex than other dementias in that it includes two related diagnoses: dementia with Lewy bodies and Parkinson's disease dementia. The timing of cognitive impairment symptoms in relation to Parkinson's movement symptoms helps doctors distinguish between them.
For families, getting the diagnosis right matters. LBD can require a somewhat different approach to managing symptoms, and some medications can make symptoms worse. That's one reason it's important to tell the healthcare provider about changes in movement, sleep, mood and behavior—not just memory.
Frontotemporal dementia (FTD) is less familiar to many families, but it is an important type of dementia to understand.
FTD results from damage to neurons in the frontal and temporal lobes of the brain, areas that play major roles in behavior, personality, decision-making, and language. It also tends to affect people at a younger age than Alzheimer's and other common dementias. How FTD presents varies depending on the areas of the brain affected.
Symptoms may include:
This can be especially hard for families because the behavior may initially be interpreted as a personality problem, depression, or another mental health issue rather than a neurological condition.
Sometimes, the answer isn't simply "Alzheimer's" or "vascular dementia."
A person can have changes associated with more than one type of dementia at the same time. This is known as mixed dementia.
One of the most common combinations is Alzheimer's disease and vascular brain changes. Alzheimer's-related changes can also occur alongside Lewy bodies.
For example, someone may have the memory difficulties associated with Alzheimer's along with the movement problems of Parkinson’s disease or fluctuations in attention associated with Lewy body dementia. Another person might have Alzheimer's-related changes combined with problems caused by vascular disease.
The brain changes associated with different conditions can overlap, and doctors are continuing to learn more about how these conditions interact.
Many families wonder: Why is it so hard to get a simple diagnosis?
This is often one of the most frustrating parts of the process for families because no single test can quickly answer the question.
As noted above, many types of dementia share symptoms. And cognitive changes can sometimes have causes that aren't dementia at all.
A healthcare provider may consider several pieces of information, including:
The National Institute on Aging (NIA) notes that symptoms can be similar among different types of dementia. So having more than one form can make an accurate diagnosis difficult.
That's why family observations along with a physician’s assessment can be so valuable.
So, if you've noticed that your dad has started missing bill payments, your mom is getting lost while driving familiar routes, or your spouse's personality has changed dramatically, take some time to write down specific examples. Those details can give a doctor a much clearer picture than simply saying, "Their memory isn't what it used to be."
You may wonder whether it really matters which type of dementia your loved one has.
It does.
Different types can affect different abilities, progress differently, and come with different symptoms that may need to be managed. Knowing the likely cause as early as possible can help healthcare professionals determine the most appropriate treatment and support strategies.
A diagnosis also helps families plan.
If your loved one is having difficulty managing medications, for example, you may need to step in sooner than expected. If driving has become unsafe, you'll need to have a conversation about transportation. If changes in behavior or mobility become more pronounced, the family may need to consider additional support at home or other care options.
Having a better understanding of what's happening doesn't make those decisions easy. But it can make them less confusing.
A dementia diagnosis can bring a lot of uncertainty. Families may hear "Alzheimer's," "vascular dementia," or "Lewy body dementia" and immediately start wondering what comes next.
While there are no simple answers, understanding the diagnosis can provide a starting point. Learning more about the condition affecting your loved one can help you understand their behavior, ask better questions of their healthcare team, and begin thinking about the support they'll need.
But it is always important to keep uppermost in your mind that a diagnosis doesn't change who your loved one is. It simply gives your family more information. And that information can help you make decisions that support their safety, maintain their dignity, and optimize their quality of life as the disease progresses.
If you're noticing changes in memory, thinking, behavior, or daily functioning, start with a conversation with your loved one's healthcare provider. Try to bring specific examples rather than relying on general observations.
Consider keeping notes for a few weeks about things such as:
Also bring a current list of medications and supplements. This can be especially useful because some medications, or combinations of medications, can contribute to cognitive symptoms.
The symptoms described here are useful for understanding the differences among the major types of dementia, but they aren't a substitute for a medical evaluation. The same symptom can have different causes in different people.
If you're looking for additional information, start with reputable organizations that regularly update their dementia resources:
We also encourage you to visit our Anthem Memory Care resources page for more information, recorded webinars, articles, and answers to common questions about dementia and memory care. We’re here to help!